TITLE:
Survival Effect of Tube Feeding in Patients with Advanced Dementia and Comorbidities
AUTHORS:
Efraim Jaul, Raz Levin, Jacob Menczel
KEYWORDS:
Advance Dementia, Tube Feeding, Survival Time
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.11,
May
27,
2014
ABSTRACT: Patients suffering from
advanced dementia who have difficulties in eating and swallowing are often tube
fed (TF). They suffer, on most occasions, from additional diseases. The effect
of tube feeding in advanced dementia patients is controversial and is largely
discussed in the medical literature. The purpose of the present study, is to
report the effect of tube feeding on the survival time in patients with
advanced dementia who suffered from additional diseases. One hundred and forty
nine patients with Functional Assessment Stage of Alzheimer Disease (FAST)
stage 5>, hospitalized in skilled geriatric nursing department
between July 2008 and December 2011 were included in the study. Oral and tub
feeding was decided following the evaluation by speech therapists at admission.
99 (66.5%) of the patients were tube fed and 50 (33.5%) received oral feeding
at admission. The mean age was 80 ± 11. Sixty
four percent of the patients were admitted from general hospitals. Comorbidities
were significantly higher in the tube fed group, median survival time was 164
days. The median survival time of the OF group was 78 days (χ2 = 0.94; p = 0.33).
Prevalence of tube feeding increased significantly from 53.85% to 90.9% in
patients with 3 risk factors such as pressure ulcers, low Hgb and low BMI. The
survival time of the tube fed patients was longer compared to patients who were
orally fed. Tube feeding in patients with dementia continues to be
controversial, and additional researchable data are helpful in the decision to
insert a tube.